DOES LONG PREOPERATIVE URETERAL DOUBLE J STENTING INFLUENCE THE OUTCOMES OF RETROGRADE URETEROSCOPY FOR URETERAL STONES? A MATCHED-PAIRED CASE-CONTROL STUDY

Authors

  • V.D. RADU “Grigore T. Popa” University of Medicine and Pharmacy Iasi
  • C. RISTESCU “Dr. C. I. Parhon” Hospital Iasi
  • I. TOMAC
  • Rodica RADU “Grigore T. Popa” University of Medicine and Pharmacy Iasi
  • P. ONOFREI “Grigore T. Popa” University of Medicine and Pharmacy Iasi
  • R.C. COSTACHE “Grigore T. Popa” University of Medicine and Pharmacy Iasi

DOI:

https://doi.org/10.22551/revmedchir.v125i2.2399

Abstract

There is a lot of debate about whether stenting is required or not prior retrograde semirigid ureteroscopy (URS). Moreover, the effect of long-term preoperative stenting on stone-free rate (SFR) and complication rate of URS. The aim of this study was to evaluate the effect of long-term preoperative double J stenting compared with non-stenting and recent pre-stenting on the outcomes of retrograde URS. Material and methods: The data of 90 patients admitted to the Urology Clinic of the Iasi “Dr. C. I. Parhon” Hospital between January 2017 and March 2020 were collected. The patients were divided into three equal groups, matched by age, sex, stone size and location: 30 non-stented patients, 30 patients stented three months before URS, and 30 patients with stents placed for over three months before URS. SFR and the rate of main URS complications (febrile syndrome and hematuria) were in the  three groups were compared. Results: There were no statistical differences between groups in terms of SFR (73%. 77%, 80%, p = 0.6). The complication rate was similar in all three groups, for both febrile syndrome and hematuria. Conclusions: Long term preoperative double J stenting does not influence the SFR of retrograde semirigid URS. In all groups, the complication rate is very low and not influenced by preoperative stenting.

Author Biographies

  • V.D. RADU, “Grigore T. Popa” University of Medicine and Pharmacy Iasi

    Faculty of Medicine
    Department of Surgery (II)

  • I. TOMAC

    “Dr. C. I. Parhon” Hospital Iasi

  • Rodica RADU, “Grigore T. Popa” University of Medicine and Pharmacy Iasi

    Faculty of Medicine
    Department of Medical Specialties (I)

  • P. ONOFREI, “Grigore T. Popa” University of Medicine and Pharmacy Iasi

    Faculty of Medicine
    Department of Morpho-functional Sciences (II)

  • R.C. COSTACHE, “Grigore T. Popa” University of Medicine and Pharmacy Iasi

    Faculty of Medicine
    Department of Surgery (II)

References

1. Tuerk C, Neisius A, Petrik A, Seitz C, Skolarikos A, Thomas K. EAU Guidelines on Urolithiasis 2016; 69(3): 468-474.
2. Ordon M, Andonian S, Blew B, Schuler T, Chew B, Pace KT. CUA Guideline: Management of ure-teral calculi. Can Urol Assoc J 2015; 9 (11-12): E837-E851.
3. El-Qadhi M. Outcome of ureteroscopy for the management of distal ureteric calculi: 5-years’ experi-ence. Afr J Urol 2015; 21(1): 67-71.
4. Yencilek F, Sarica K, Erturhan S, Yagci F, Erbagci A. Treatment of Ureteral Calculi with Semirigid Ureteroscopy: Where Should We Stop? Urol Int 2020; 84(3): 260-264.
5. Hollenbeck BK, Schuster TG, Faerber GJ, Wolf Jr JS. Comparison of Outcomes of Ureteroscopy for Ureteral Calculi Located Above and Below the Pelvic Brim. Urology 2001; 58(3): 351-356.
6. Rubenstein RA, Zhao LC, Loeb S, Shore DM, Nadler RB. Prestenting improves ureteroscopic stone-free rates. J Endourol 2007; 21: 1277-1280.
7. Netsch C, Knipper S, Bach T, Herrmann TR, Gross AJ. Impact of preoperative ureteral stenting on stone-free rates of ureteroscopy for nephroureterolithiasis: a matched-paired analysis of 286 patients. Urology 2012; 80: 1214-1219.
8. Jessen JP, Breda A, Brehmar M, et al. International collaboration of presenting for ureteroscopy. J Endourol 2016; 30(3): 268-273.
9. Chu L, Sternberg KM, Averch TD. Preoperative Stenting Decreases Operative Time and Reoperative Rates of Ureteroscopy. J Endourol 2011; 25(5): 751-754.
10. Assimos D, Crisci A, Culkin D, et al. URS Global Study Group. Preoperative JJ stent placement in ureteric and renal stone treatment: results from the Clinical Research Office of Endourological Society (CROES) ureteroscopy(URS) Global Study. BJU Int 2016; 117(4): 648-654.
11. Navetta AF, Elmekresh A, Doersch K, et al. Preoperative ureteral stenting prior to ureteroscopy for management of urolithiasis does not impact the postoperative return for unplanned care. Urol Ann 2019; 11(3): 282-286.
12. Nevo A, Mano R, Baniel J, Lifshirz DA. Ureteric stent dwelling time: a risk for post-ureteroscopy sepsis. BJU Int 2017; 120: 117-122.
13. Werthemann P, Weikert S, Enzmann T, Schostak M, Lebentrau S. A Stent for Every Stone? Prestenting Habits and Outcomes from a German Multicenter Prospective Study on the Benchmarks of Ureteroscopic Stone Treatment (BUSTER). Urol Int 2020; 104(5-6): 431-436.
14. Lee MH, Lee IJ, Kim TJ, et al. The Effect of Short-Term Preoperative Ureteral Stenting on the Out-comes of Retrograde Intrarenal surgery for Renal Stones. World J Urol 2019; 37(7): 1435-1440.
15. Yang Y, TangY, Bay Y, Wang X, Feng D, Han P. Preoperative double-J stent placement can improve the stone-free rate for patients undergoing ureteroscopic lithotripsy: a systematic review and meta-analysis. Urolithiasis 2018; 46(5): 493-499.
16. Nevo A, Mano R, Schreter E, Lifshitz D. Clinical Implications of Stent Culture in Patients with In-dwelling Stents Prior to Ureteroscopy. J Urol 2017; 198: 116-121.
17. Southern JB, Higgins AM, Young AJ, Kost KA, Schreiter BR, Clifton M, Fulmer BR, Garg T. Risk factors for Postoperative Fever and Systemic Inflammatory Response Syndrome After Ureteroscopy for Stone Disease. J Endourol 2019; 33(7): 516-522.
18. Hameed DA, Safwat AS, Osman MM, Gadelmoula MM, Kurkar A, Elgammal MA. Outcome of ureteral distensibility on the success of ureteroscopy: A prospective hospital-based descriptive study. Afr J Urol 2016; 23(1): 33-37.
19. Lumma PP, Schneider P, Strauss A, et al. Impact of ureteral stenting prior to ureteroscopy on stone-free rates and complications. World J Urol 2013; 31(4): 855-859.
20. Cetti RJ, Biers S, Keoghane SR. The Difficult Ureter: What Is the Incidence of Pre-Stenting? Ann R Coll Surg Engl 2011; 93(1): 31-33.
21. Radu VD, Siriopol D, Ristescu C, et al. Retrograde semirigid ureteroscopy versus extracorporeal shock wave lithotripsy in the treatment of ureteral calculi between 5-15 mm. Rev Med Chir Soc Med Nat Iasi 2020; 124(2): 267-272.
22. Negru I, Pangal A, Pricop C, Mihălceanu E, Costăchescu G, Negru D. Management of renal colic during pregnancy. Rev Med Chir Soc Med Nat Iasi 2018; 122(1): 109-115.

Additional Files

Published

2021-06-30